Non-integrated Groups Research Articles

Implementation of intentionally structured psychosocial through folk games and traditional sports in elementary school students

This study aimed to examine the impact of intentionally structured psychosocial programs through folk games and traditional sports on elementary school students. Psychosocial factors influence individual thoughts and behaviors, and traditional games and sports are known for their character-building and cultural values. The research used a pretest-posttest group design with a quantitative approach, focusing on 5th-grade students from Sumur Batu 06 Public Elementary School in Central Jakarta. The primary instrument was the Questionnaire on Psychosocial Adjustment Needs of Grade 7 Students, covering social cognitive, socio-emotional, social, teacher-student, peer, parent, and sibling relationships. The study followed Kendellen's model, which emphasizes focusing on one psychosocial component per lesson, introducing it at the lesson's beginning, teaching it throughout the lesson, and reviewing it at the end. Data analysis was conducted using SPSS version 22, including only students with at least 80% attendance who completed both pre-tests and post-tests. Normality tests confirmed that data from both integrated and non-integrated groups were normally distributed, while homogeneity tests showed that the samples were from a homogeneous population. Paired sample t-tests revealed significant improvements in psychosocial outcomes for both groups, with the integrated group showing a t-value of 7.453 (Sig. 0.000) and the non-integrated group a t-value of 5.121 (Sig. 0.000). These results indicate a significant positive effect of psychosocially integrated traditional games and sports on the psychosocial development of elementary school students. Keywords: Intentionally Structured, Psychosocial, Sports, Traditional Games

Music as a Tool in Learning: Improvements in Basic Competences in Children Studying an Integrated Music Programme

Son Serra (Son Serra State Primary School), in Mallorca, is the first state-run school in the Balearic Islands to offer integrated music and non-integrated pathways to students in the same class. This study aims to compare the results of students from the fourth year of primary education from both pathways in a maths, Spanish, Catalan and English language level tests. Socioeconomic information on the children's families was also gathered. The results showed students from the integrated music group always outperforming their peers from the non-integrated group in the four assessed competences. Having established that the families’ socioeconomic status does not condition these results, the benefits of receiving more music practice were discussed.

Impact of health system specialty pharmacies on total cost of care in cancer treatment, a multisite review.

Integrated delivery networks can use medically integrated dispensing of oral oncolytics on site through health system specialty pharmacies. There is little published research examining cost savings. Our objective was to demonstrate the financial value of health system specialty pharmacies among patients receiving oral oncolytics dispensed through fully, partially, and non-integrated dispensing strategies. This was a retrospective cohort study of adult patients from Symphony Health's Integrated Dataverse® repository who filled a prescription for an agent of interest from 7/1/16-6/30/20 that was written within 25 US health systems. Outcomes included costs, healthcare resource utilization, and duration of therapy. In total, 36,816 patients were included; 986 patients (2.7%) integrated, 1,822 (4.9%) partially integrated, and 34,008 (92.4%) non-integrated. Mean 6-month medical charge and oncolytic prescription costs were lower for the integrated group ($36,831; $55,786) than the partially integrated ($46,304, p = 0.053; $63,295, p = 0.071) and non-integrated groups ($54,261, p < 0.001; $65,005, p = 0.004). In most healthcare resource utilization categories, the integrated group had the lowest patient percentage utilizing medical care. Duration of therapy was lower on average by ∼3 months in the integrated vs non-integrated group, which may represent closer monitoring of patient medical records and need for fills vs autoship practices. Patients receiving oral oncolytics through medically integrated dispensing at health system specialty pharmacies may have lower medical and pharmacy costs and decreased healthcare resource utilization. This study adds to the growing body of literature supporting integrated delivery networks and integrated dispensing. Further research is needed to demonstrate the value of medically integrated dispensing through health system specialty pharmacies in the delivery of treatment to patients with cancer and other high-cost diseases.

Zwitterionic Polysulfobetaine Coating and Antiplatelet Liposomes Reduce Fouling in Artificial Lung Circuits.

The artificial lung has provided life-saving support for pulmonary disease patients and recently afforded patients with severe cases of COVID-19 better prognostic outcomes. While it addresses a critical medical need, reducing the risk of clotting inside the device remains challenging. Herein, a two-step surface coating process of the lung circuit using Zwitterionic polysulfobetaine methacrylate is evaluated for its nonspecific protein antifouling activity. It is hypothesized that similarly applied coatings on materials integrated (IT) or nonintegrated (NIT) into the circuit will yield similar antifouling activity. The effects of human plasma preconditioned with nitric oxide-loaded liposome on platelet (plt) fouling are also evaluated. Fibrinogen antifouling activities in coated fibers are similar in the IT and NIT groups. It however decreases in coated polycarbonate (PC) in the IT group. Also, plt antifouling activity in coated fibers is similar in the IT and NIT groups and is lower in coated PC and Tygon in the IT group compared to the NIT group. Coating process optimization in the IT lung circuit may help address difference in the coating appearance of outer and inner fiber bundle fibers, and the NO-liposome significantly reduces (86%) plt fouling on fibers indicating its potential use for blood anticoagulation.

Two approaches for newborns with critical congenital heart disease: a comparative study.

Prenatal diagnosis and planned peripartum care is an unexplored concept in China. This study aimed to evaluate the effects of the "prenatal diagnosis and postnatal treatment integrated model" for newborns with critical congenital heart disease. The medical records of neonates (≤ 28days) admitted to Fuwai Hospital were reviewed retrospectively from January 2019 to December 2020. The patients were divided into "prenatal diagnosis and postnatal treatment integrated group" (n = 47) and "non-integrated group" (n = 69). The age of admission to the hospital and the age at surgery were earlier in the integrated group than in the non-integrated group (5.2 ± 7.2days vs. 11.8 ± 8.0days, P < 0.001; 11.9 ± 7.0days vs. 16.5 ± 7.7days, P = 0.001, respectively). The weight at surgery also was lower in the integrated group than in the non-integrated group (3.3 ± 0.4kg vs. 3.6 ± 0.6kg, P = 0.010). Longer postoperative recovery time was needed in the integrated group, with a median mechanical ventilation time of 97h (interquartile range 51-259h) vs. 69h (29-168h) (P = 0.030) and with intensive care unit time of 13.0days (8.0-21.0days) vs. 9.0days (4.5-16.0days) (P = 0.048). No significant difference was observed in the all-cause mortality (2.1 vs. 8.7%, P = 0.238), but it was significantly lower in the integrated group for transposition of the great arteries (0 vs. 18.8%, log rank P = 0.032). The prenatal diagnosis and postnatal treatment integrated model could significantly shorten the diagnosis and hospitalization interval of newborns, and surgical intervention could be performed with a lower risk of death, especially for transposition of the great arteries.

Neonatal surgical outcomes after prenatal diagnosis of complex congenital heart disease: experiences of a perinatal integrated diagnosis and treatment program.

This study aimedto evaluate neonatal surgical outcomes of patients diagnosed with complex congenital heart disease (CHD) during pregnancy and treated by the newly initiated "perinatal integrated diagnosis and treatment program (PIDTP)". We reviewed clinical data of 207 neonates (surgical age ≤ 28days) who underwent cardiac surgeries in a single center from January 2017 to December 2018, including 31 patients with referrals from the "PIDTP" (integration group) and 176 patients with routine referral treatment (non-integrated group). In the integration group, median admission age was 0days and median age at surgery was 4days. In the non-integrated group, median admission age was 8days (P = 0.001) and median age at surgery was 13days (P = 0.001). The emergency surgery rate in patients with duct-dependent defects was 36% in the integration group and 59% (P = 0.042) in the non-integrated group, respectively. The in-hospital mortality was 16% in the integration group and 14% (P = 0.78) in the non-integrated group. The 2-year cumulative survival rate after surgery was 83.9% ± 6.6% in the integration group and 80.3% ± 3.1% (P = 0.744) in the non-integrated group. According to multivariable regression analysis, independent risk factors for early mortality of overall neonatal cardiac surgery were low body weight, high serum lactate level, postoperative extracorporeal membrane oxygenation (ECMO) support and prolonged cardiopulmonary bypass (CPB) time. PIDTP shortens the postnatal transit interval, reduces the emergency operation rate of neonatal critical CHD, and provides better preoperative status for surgery. Patients treated by the PIDTP tend to have more complicated anatomical deformity and a greater requirement for the operation and postoperative management, but early outcome and follow-up prognosis are satisfactory.

Factors Associated with Duration of Overall Treatment Time for Cervical Cancer Treated with Definitive Chemoradiotherapy.

IntroductionFor women with intact cervical cancer treated by definitive chemoradiotherapy, the adverse impact of treatment prolongation is well-established. We aimed to identify potentially modifiable factors associated with the unwanted increase in the time required to complete the prescribed course of therapy.MethodsWe retrospectively examined treatment records of 104 consecutive cervical cancer patients receiving chemoradiation for cervical cancer, which included cervical high-dose-rate intracavitary brachytherapy performed at a single referral center. Association of factors, including distance to care, driving time, and income level with overall treatment time, was explored.ResultsGuideline-concordant treatment duration was achieved in 34% of cases. There was no significant correlation between treatment duration and any of the patient-related characteristics assessed in this study. Transitioning of the radiation oncology physician staffing at the brachytherapy center from a private practice non-integrated group to a large integrated group was associated with a decrease in mean overall treatment time, 61 vs. 68 days, p = 0.007.ConclusionsWe did not identify a modifiable patient-related factor amenable to a financial intervention. Administration of brachytherapy within an integrated system resulted in a shortened duration of the entire course of therapy for intact cervical cancer.

Integration of hepatitis B virus S gene impacts on hepatitis B surface antigen levels in patients with antiviral therapy

The aim of this study is to investigate the impact of hepatitis B virus (HBV) S gene integration on serum hepatitis B surface antigen (HBsAg) levels in chronic hepatitis B with long-term nucleos(t)ide analogue (NUC) therapy. Chronic hepatitis B patients who performed liver biopsy at baseline and treated with long-term NUC therapy were recruited. The integration of HBV S gene in baseline liver biopsy specimen was detected by Alu polymerase chain reaction method. Serum HBsAg levels were measured at baseline and the second year and the fourth year after NUC therapy by Roche reagent, respectively. Serum HBsAg levels between HBV S gene integrated group and nonintegrated group were compared and analyzed. Seventy patients were eligible for this study. Among them, 11 (15.7%) were found to have HBV S gene integration in their baseline liver biopsy specimens. Similar significant decrease of HBsAg levels was found in both integrated and nonintegrated groups (2.63 vs 2.65log IU/mL, P=0.478) after the first 2years of NUC therapy. Thereafter, the decrease of HBsAg level from 2 to 4years after therapy was largely unchanged in integrated group as compared with that of nonintegrated group (0.1 vs 2.53log IU/mL, P=0.002), with statistical difference. Serum HBsAg could be originated from the expression of the integrated HBV S gene in patients with S gene integration, which implicated the limitations when regarding HBsAg as a surrogate biomarker of covalently closed circular DNA activity and as an indicator of safe NUC discontinuation.

An integrated terminal operating system for enhancing the efficiency of seaport terminal operators

A seaport terminal is a vital link in the global supply chain which has a profound impact on port competitiveness and international trade. However, ongoing worldwide economic slumps, coupled with the proliferation of terminal operators, have created a glut for terminal-related logistics services and intensified competition among terminal operators. As a way to better utilize the existing terminal infrastructure and enhance terminal operating efficiencies, we propose an integrated terminal operating system that can reduce duplicated investments in equipment, redundant workforce, and non-value-adding processes, while standardizing terminal services including loading/unloading, discharging, and transferring cargo. To verify the usefulness of the proposed integrated terminal operating system, we develop key performance indicators of terminal operations which help to measure the comparative performances of both an integrated group and a non-integrated group of terminal operators and then formulate viable strategic options for creating “win–win” situations for terminal operators and their stakeholders including port administrators. In so doing, we examine the current practices of terminal operators at the Incheon Inner harbor in Korea through in-depth interviews and then identify critical success factors for integrated terminal operations based on a questionnaire survey and analytic hierarchy process. These factors include the terminal operator’s cargo attraction level, cargo turnover ratio, cargo storage capacity, and ability to comply with government rules and policies.

Teaching nature of science within a controversial topic: Integrated versus nonintegrated

AbstractThis study investigated the influence of two different explicit instructional approaches in promoting more informed understandings of nature of science (NOS) among students. Participants, a total of 42 students, comprised two groups in two intact sections of ninth grade. Participants in the two groups were taught environmental science by their regular classroom teacher, with the difference being the context in which NOS was explicitly taught. For the “integrated” group, NOS instruction was related to the science content about global warming. For the “nonintegrated” group, NOS was taught through a set of activities that specifically addressed NOS issues and were dispersed across the content about global warming. The treatment for both groups spanned 6 weeks and addressed a unit about global warming and NOS. An open‐ended questionnaire, in conjunction with semistructured interviews, was used to assess students' views before and after instruction. Results showed improvements in participants' views of NOS regardless of whether NOS was integrated within the regular content about global warming. Comparison of differences between the two groups showed “slightly” greater improvement in the informed views of the integrated group participants. On the other hand, there was greater improvement in the transitional views of the nonintegrated group participants. Therefore, the overall results did not provide any conclusive evidence in favor of one approach over the other. Implications on the teaching and learning of NOS are discussed. © 2006 Wiley Periodicals, Inc. J Res Sci Teach 43: 395–418, 2006

An analysis of the integration between articular cartilage and nondegradable hydrogel using magnetic resonance imaging

A hydrogel is a highly hydrated polymer gel suitable for use as a scaffold for tissue engineering. One important application is to the repair of cartilage defects due to injury or osteoarthritis. Integration of the hydrogel with surrounding tissue is critical for the long-term functionality of the implant; however direct visualization of integration is difficult and invasive. Accordingly, we used MRI to noninvasively investigate the integration of hydrogel in cartilage. Two integration methods were assessed: (1) cartilage-initiated and (2) chemical, using chondroitin sulphate-methacrylate-aldehyde (CS-MA-ald) as an adhesive. These were compared to a control group, that is, standard, nonintegrated hydrogel photopolymerization. Spatial variation of the transverse relaxation time, T(2), across the transition region was used to determine the effectiveness of integration. In the CS-MA-ald group only, two interfaces were found. This provides evidence of an intermediate adhesive layer between hydrogel and cartilage. Second, the thickness of the transition region between hydrogel to cartilage in the CS-MA-ald group was 1.32 mm as compared to 1.20 mm and 1.17 mm in the tissue-initiated and nonintegrated groups, respectively. We interpret this as a more gradual transition region of hydrogel to cartilage and hence a greater degree of integration when an adhesive layer is present.

Dr. Ross and Ms. Ellason Reply

Back to table of contents Previous article Next article Letter to the EditorFull AccessDr. Ross and Ms. Ellason ReplyCOLIN A. ROSS, M.D., and JOAN W. ELLASON, M.A., L.P.C., COLIN A. ROSSSearch for more papers by this author, M.D., and JOAN W. ELLASONSearch for more papers by this author, M.A., L.P.C., Dallas, Tex.Published Online:1 Sep 1998https://doi.org/10.1176/ajp.155.9.1304aAboutSectionsView EPUB ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InEmail To the Editor: We agree with most of the methodological limitations pointed out by Drs. Powell and Howell. Our study lacked controls and a standardized treatment protocol, and subjects were recruited at their most symptomatic. Some of the improvement was probably due to spontaneous remission. The efficacy of psychotherapy for dissociative identity disorder is not a scientific fact.We disagree that a tautology occurred because of our use of outcome measures to assign subjects to integrated versus nonintegrated groups. Only the DSM-IV criteria for dissociative identity disorder from the Dissociative Disorders Interview Schedule were used in this assignment. No other outcome measures influenced this assignment.On the basis of our data, it seems unlikely that properly conducted therapy for dissociative identity disorder causes deterioration or chronic illness. Many people who receive this diagnosis make remarkable recoveries, given their degree of baseline comorbidity. Our data support allocation of resources to more rigorous prospective treatment outcome studies. In light of the methodological limitations of our study, one can no more attribute therapeutic causality to medications than to psychotherapy or spontaneous remission. There are many ethical, logistical, and methodological problems in designing and conducting rigorous treatment outcome studies for dissociative identity disorder. Treatment to stable integration often takes 4 or 5 years. It would be unethical to randomly assign subjects to a placebo group for that long. Therapists who believe in the specificity of psychotherapy for dissociative identity disorder would be unlikely, as a matter of personal conscience, to participate in a study that involved random assignment to 5 years of placebo treatment. Therefore, one could not recruit therapists to the study. The likelihood that patients would stay in the study in the placebo control condition for that long without dropping out is minimal.Prospective random assignment to placebo or waiting-list control groups in a treatment study for dissociative identity disorder is impractical. We suggest that different schools of thought should be compared to each other. At present, our school of thought is the only one that has provided prospective treatment outcome data with scientific methodology of any kind. The burden is now on competing schools of thought to match or exceed this level of methodology and to demonstrate a superior outcome.We plan to initiate a prospective treatment outcome study beginning at the time of initial diagnosis. It will include measures of health care utilization, employment status, clinical variables, and treatment modalities employed.Another approach would be to screen a large population base, such as all individuals covered by a major managed care company. Subjects with undiagnosed dissociative identity disorder could be identified with the test battery used in our study. Half could be randomly assigned to the treatment we recommend, and half could be left undiagnosed and tracked as they receive conventional treatment for other comorbid disorders.We hope that such studies are completed over the next decade and subjected to rational, reasonable methodological scrutiny such as that provided by Drs. Powell and Howell. FiguresReferencesCited byDetailsCited By Volume 155Issue 9 September 1998Pages 1304a-1305 Metrics History Published online 1 September 1998 Published in print 1 September 1998

Effects of Toys on the Social Behavior of Preschool Children in Integrated and Nonintegrated Groups

This study investigated the influence of social and isolate toys on the social behavior of integrated and nonintegrated groups of preschool children during free play time. Eighteen handicapped and six nonhandicapped children participated. Using a time-sampling technique, data were obtained on the frequency of social behavior. Results showed that under social toy conditions, children engaged in social behavior more often than during any other condition. In addition, the incidence of social play was higher in integrated groups than in nonintegrated groups. Based on the results of this study, toys are conceptualized as a setting event for the social behavior of preschool children. Selection of toys is presented as a viable and nonintrusive method of promoting social interaction between handicapped and nonhandicapped preschool children.